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Degloving injury

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https://www.readbyqxmd.com/read/29773764/degloving-lower-leg-injury-the-importance-of-additional-treatment-negative-pressure-and-hyperbaric-oxygen-therapy
#1
Piotr Stabryła, Joanna Kulińska, Łukasz Warchoł, Anna Kasielska-Trojan, Wojciech Gaszyński, Bogusław Antoszewski
Degloving injury poses a severe therapeutic challenge concerning both trauma and plastic surgery. The injury involves separation of skin and subcutaneous tissue from fascia and muscles. Treatment is often long-lasting and brings unsatisfying results due to the extent of damage, risk of infection and massive blood loss. In this article, we present the management and therapeutic outcomes of a patient admitted due to the degloving injury of the lower extremity caused by workplace accident. We described the complexity of treatment including surgical intervention as well as additional treatment, which combined brought good esthetic outcome...
April 30, 2018: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29768532/effect-of-cilostazol-in-experimental-model-of-degloving-injuries-in-rat-limbs
#2
André Pazio, Vital Burko Santos, Guataçara Schenfelder Salles Junior
PURPOSE: To evaluate the effect of the cilostazol on the evolution of partially avulsed flaps, using experimental model of cutaneous degloving in rat limbs. METHODS: A controlled and randomized experimental study was carried out in which the blood flow and the percentage of flap necrosis were evaluated. We compared the study group, which received cilostazol, and the control group, which received enteral saline solution in the postoperative period. The blood flow in the flap was evaluated through Laser Doppler flowmetry, and a planimetry using the IMAGE J® software was employed for the calculation of the area of necrosis...
April 2018: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/29737002/lower-limb-reconstruction-with-chimeric-flaps-the-quad-flap
#3
Solomon M Azouz, Nikki A Castel, Aparna Vijayasekaran, Alanna M Rebecca, Salvatore C Lettieri
Early soft-tissue coverage is critical for treating traumatic open lower-extremity wounds. As free-flap reconstruction evolves, injuries once thought to be nonreconstructable are being salvaged. Free-tissue transfer is imperative when there is extensive dead space or exposure of vital structures such as bone, tendon, nerves, or blood vessels. We describe 2 cases of lower-extremity crush injuries salvaged with the quad flap. This novel flap consists of parascapular, scapular, serratus, and latissimus dorsi free flaps in combination on one pedicle...
May 7, 2018: Microsurgery
https://www.readbyqxmd.com/read/29734567/random-flap-survival-with-hyperbaric-oxygen-daily-versus-twice-daily-treatments
#4
Rachel Weber, Andrew Silver, Shelley J Williams, Linda Stephenson, Phillip C Usera, Fan Zhang, Honglin Tian, Wei Yang, Wei Z Wang, Xin Hua Fang, William A Zamboni, Richard Baynosa
Purpose: Hyperbaric oxygen (HBO₂) therapy is used to improve the survival of compromised flaps. Compromised flaps are complications encountered postsurgically, or in traumatic degloving or avulsion injuries. Failed flaps lead to persistence of the defect, requirement of another donor site, and psychosocial sequelae. Although evidence of the benefit of HBO₂ therapy is significant, there is no consensus on the optimal treatment regimen. The purpose of this study is to examine whether twice-daily treatments (BID HBO₂) provide additional benefit compared to daily treatments (QD HBO₂) in a rat compromised random flap model...
March 2018: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/29725514/actinomycosis-of-distal-phalanx-twenty-years-after-flap-reconstruction-of-index-finger-a-case-report
#5
N Prashant, A Azuhairy
Actinomycosis is a chronic granulomatous suppurative infection caused by anaerobic bacteria from genus Actinomyces which are normal flora of mouth, colon and vagina. Actinomycosis of upper extremity is rare. We report a case of actinomycosis of the distal phalanx of finger many years after flap reconstruction. The patient presented with two months' history of chronic discharging sinus from the tip of his right index finger, which had sustained a degloving injury 20 years previously. It had been treated with an anterior chest wall flap which had healed uneventfully but was bulky due to excess tissue from the donor site...
March 2018: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29706734/thoracoumbilical-flap-anatomy-technique-and-clinical-applications-in-upper-limb-reconstruction-in-the-era-of-microvascular-surgery
#6
Ravikiran Naalla, Moumita De, Rakesh Dawar, Shashank Chauhan, Maneesh Singhal
Purpose: Microvascular reconstruction is the standard of care for salvage of soft tissue defects in complex upper extremity due to their distinct advantages over the pedicled flaps. However, in the era of microsurgery, pedicled flaps have an acceptable significant role for reconstruction of complex soft tissue defects. The authors aim to demonstrate the versatility of pedicled thoracoumbilical flap (TUF) in selected clinical scenarios. Patients and Methods: Retrospective analysis of patients who underwent TUF for upper limb posttraumatic reconstruction was performed between January 2016 and October 2017...
April 2018: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/29627114/partial-medial-second-toe-pulp-free-flap-and-dermal-substitute-with-skin-graft-for-salvage-reconstruction-of-a-complete-skin-envelope-degloving-of-the-small-finger
#7
V Calafat, C Strugarek, D Montoya-Faivre, F Dap, G Dautel
Skin envelope degloving of fingers are rare injuries that require rapid care and surgical treatment. Mostly caused by ring finger injuries, these traumas include bone, tendon and neurovascular pedicle damage. The authors present an unusual case of finger degloving limited exclusively to the skin envelope, without skeletal, tendinous or vascular lesion. This rare case of skin envelope degloving rendered microsurgical revascularization impossible. The authors report the results at 12 months following salvage reconstruction combining a partial second toe pulp free flap for the volar side and a dermal substitute with a thin skin graft for the dorsum...
April 4, 2018: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29621078/a-patient-with-severe-lower-face-degloving-injury
#8
Ivo Cavalcante Pita Neto, Jéferson Martins Pereira Lucena Franco, Eduardo Chaves Moreno, Pablo Pita, Francisco Aurelio Lucchesi Sandrini, David Gomes de Alencar Gondim
Avulsions of mandible are among the most devastating lesions observed in cranio-maxillofacial traumas. They present an important health problem because of the high risk of morbidity related to deformities that cause functional limitations and esthetic changes. The avulsions commonly result from high-energy effects, which cause complete or partial separation of the mandibular bone of the face. As a result of the intense aggression, the skin and subcutaneous tissues of the bone are usually removed, affecting muscles, fascia, blood vessels, and the surrounding nerves...
April 4, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29609971/the-use-of-arteriovenous-anastomosis-for-venous-drainage-during-tamai-zone-i-fingertip-replantation
#9
Fei Wu, Xiaofang Shen, Kyle R Eberlin, Zhibo Sun, Xiao Zhou, Mingyu Xue
PURPOSE: The purpose of this study was to evaluate outcomes for patients sustaining a distal fingertip amputation who underwent replantation witharteriovenous anastomosis for venous drainage over a one year period at our institution. This technique has been utilized when insufficient veins are identified in the amputated part for standard veno-venous anastomosis. METHODS: A retrospective study was performed on patients presenting from 2013 to 2014. Guillotine, crush, and avulsion/degloving injuries were included if they underwent fingertip (Tamai Zone I) replantation with arterial anastomosis for vascular inflow and arteriovenous anastomosis for venous drainage...
March 27, 2018: Injury
https://www.readbyqxmd.com/read/29556506/a-rare-case-of-severe-third-degree-friction-burns-and-large-morel-lavallee-lesion-of-the-abdominal-wall
#10
Darnell J Brown, Kuo Jung G Lu, Kristina Chang, Jennifer Levin, John T Schulz, Jeremy Goverman
Background: Morel-Lavallee lesions (MLLs) are rare internal degloving injuries typically caused by blunt traumatic injuries and most commonly occur around the hips and in association with pelvic or acetabular fractures. MLL is often overlooked in the setting of poly-trauma; therefore, clinicians must maintain a high degree of suspicion and be familiar with the management of such injuries, especially in obese poly-trauma patients. Case presentation: We present a 30-year-old female pedestrian struck by a motor vehicle who sustained multiple long bone fractures, a mesenteric hematoma, and full-thickness abdominal skin friction burn which masked a significant underlying abdominal MLL...
2018: Burns and Trauma
https://www.readbyqxmd.com/read/29409406/the-bilobed-racquet-flap-or-extended-seagull-flap-for-thumb-reconstruction-a-case-report
#11
José Couceiro, Mariangeles De la Red-Gallego, Luis Yeste, Higinio Ayala, Manuel Sanchez-Crespo, Olga Velez, Rebeca Barcenilla, Fernando Del Canto
The treatment of extensive soft tissue defects in the thumb with dorsal metacarpal artery flaps has been previously reported in the literature. Island flaps from the dorsum of the index and long fingers have been the subject of many reports and studies. However, when the defect involves the whole thumb, a 360° circumferential defect, standard first or second dorsal metacarpal artery flaps are usually insufficient. There are fewer reports on the use of bilobed flaps for this application and we have found no reports on the use of bilobed racquet flaps or extended seagull flaps as treatment for this condition...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29394972/extended-islanded-reverse-sural-artery-flap-for-staged-reconstruction-of-foot-defects-proximal-to-toes
#12
Muhammad Amin Yousaf, Zain Ul Abidin, Kamran Khalid, Ata Ul Haq, Farrukh Aslam Khalid, Faraz Ahmad Tarar, Muhammad Umar Asif, Moazzam Nazeer Tarar
Obective:To assess the outcome of extended delayed reverse sural artery flap for reconstruction of foot defects proximal to toes in terms of flap survival, complication and extended area. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Jinnah Burn and Reconstructive Surgery Centre, Lahore, from February 2015 to April 2017. METHODOLOGY: Cases who underwent delayed sural artery flap were inducted. Preoperative hand-held doppler was done to confirm the location of perforator...
February 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29360674/reconstruction-of-a-circumferential-upper-extremity-soft-tissue-defect-with-a-dermal-regeneration-template-and-skin-grafting
#13
Ji H Son, Blaine Bafus, Anjay Khandelwal, Kyle J Chepla
Extensive degloving injuries of the upper extremity are rare and pose unique reconstructive challenges. Circumferential loss of soft tissue coverage over the elbow treated by skin grafting is often complicated by elbow contracture and decreased range of motion, requiring secondary contracture release and free-flap reconstruction to restore function. As an alternative approach, we report a good outcome after the use of a dermal regenerative template and subsequent split-thickness skin grafting. A 38-year-old right hand dominant man presented with circumferential degloving injury of the entire right upper extremity to the level of the chest wall after an industrial accident...
March 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29325832/the-pics-technique-a-novel-approach-for-residual-curvature-correction-during-penile-prosthesis-implantation-in-patients-with-severe-peyronie-s-disease-using-the-collagen-fleece-tachosil
#14
Georgios Hatzichristodoulou
BACKGROUND: Correction of residual curvature during inflatable penile prosthesis (IPP) implantation in patients with Peyronie's disease (PD) by plaque incision and grafting is a common approach. AIM: To present a novel technique for residual curvature correction during IPP implantation using collagen fleece (TachoSil, Baxter Healthcare Corp, Deerfield, IL, USA). METHODS: After the IPP (Titan Touch, Coloplast, Minneapolis, MN, USA) is placed, the implant is inflated maximally...
March 2018: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/29310353/complex-pelvic-ring-injuries-associated-with-floating-knee-in-a-poly-trauma-patient-a-case-report
#15
Yuebin Zhou, Honggang Guo, Zhiwei Cai, Yuan Zhang
RATIONALE: Complex pelvic ring fracture associated with floating knee is comparatively rare which usually results from high-energy trauma including vehicle-related accidence, falls from height, and earthquake-related injury. To our knowledge, few literatures have documented such injuries in the individual patient. Management of both injuries present challenges for surgical management and postoperative care. The purpose of this study is to prove the feasibility and benefits of damage control orthopedics (DCO)...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29304820/degloving-injuries-with-versus-without-underlying-fracture-in-a-sub-saharan-african-tertiary-hospital-a-prospective-observational-study
#16
Hervé Monka Lekuya, Rose Alenyo, Isaac Kajja, Alexander Bangirana, Ronald Mbiine, Ater Ngoth Deng, Moses Galukande
BACKGROUND: Degloving injuries are surgical conditions in which an extensive portion of skin and subcutaneous tissue is detached from the underlying fasciae, muscles, or bone surface. Frequently, there is an association of fracture underlying the degloved area. We aimed to compare the short-term outcomes of degloving injuries with and without underlying fracture. METHODS: A prospective cohort study was conducted. We recruited patients with degloving injuries, and followed them up for 30 days to assess the outcomes...
January 5, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29218292/primary-one-stage-reconstruction-in-complex-facial-avulsion-injury
#17
Abhishek Ghosh
Complex facial injuries with soft tissue degloving and bony avulsion are very devastating to the patient. Partial degloving injuries are described but hemifacial degloving with zygoma avulsion are rare. The author presents a case of post-traumatic degloving of the left upper lip, nose, part of forehead, upper and lower eyelids and cheek with avulsion of the left zygoma. The management included immediate resuscitation and early surgery to reposition the skeletal as well as soft tissue avulsion. The wound was thoroughly washed and primary repositioning and fixation were done...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29166258/application-of-a-skin-adhesive-to-maintain-seal-in-negative-pressure-wound-therapy-demonstration-of-a-new-technique
#18
Murad Karadsheh, Josh Nelson, Benjamin Rechner, Richard Wilcox
Optimal wound healing with negative pressure wound therapy (NPWT) relies on a properly sealed vacuum system. Anatomically difficult wounds impair the adhesive dressing, which results in air leaks that disrupt the integrity of the NPWT system and hinder wound healing. OBJECTIVE: The authors demonstrate a new technique using a cyanoacrylate-based tissue adhesive to maintain an airtight, durable seal in NPWT. MATERIALS AND METHODS: A 52-year-old woman with a degloving injury to the right thigh extending into the groin, resulting in massive necrosis, presented to the emergency department...
November 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29115657/wrapping-degloved-fingers-with-a-distal-based-radial-forearm-perforator-flap-a-repair-method-for-multiple-digital-degloving-injury
#19
Yusuf Kenan Çoban, Özcan Öcük, Kaan Bekircan
Degloving hand injuries present challenging situations to hand surgeons as they present with difficulties in reconstructive microsurgery, particularly in multiple digital injuries. Time is a limiting factor when multiple degloving finger amputations are present. Thus, we proposed a repair method for multiple degloving finger injuries that involves coverage with a distal-based reverse forearm flap of all injured fingers in a two-stage procedure. Early vigorous physical therapy after pedicle division of the flap at postoperative third week eliminates joint stiffness problems at wrist and metacarpophalangeal joints...
November 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28942407/endoscopic-surgical-management-of-a-large-morel-lavall%C3%A3-e-lesion
#20
Andrew Walls, Samuel E McMahon, Jonathan MacDonald, Jonathan Bunn
The Morel-Lavallée lesion is a closed degloving injury that usually occurs following high-energy trauma. We present a case demonstrating endoscopic management of this lesion. A 44-year-old man fell from scaffolding. Initial assessment demonstrated no significant injury. An ultrasound scan 2 days post injury revealed a large fluid collection along the lateral right thigh. This subsequently became infected and did not respond to antibiotic therapy.Due to the extent of the lesion, we were reluctant to perform a traditional open drainage...
September 23, 2017: BMJ Case Reports
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